Tisch, Ira S

Tisch, Ira S is an individual health care provider with primary practice located at 555 French Rd Suite 103, New Hartford NY 13413-1044. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Nephrology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Nephrology is his primary health care specialty. Tisch, Ira S can be contacted via phone (315) 735-3541.

Contact Information

Primary practice address
555 French Rd Suite 103 New Hartford NY 13413-1044
Phone: (315) 735-3541
Fax: (315) 724-3255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 1576065 New York
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 1576065 New York

Profile Details

NPI number 1629022967
LBN Legal business name Tisch, Ira S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jul 30th, 2009 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629022967 NPPES
New York MEDICAID 01748907

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